Posts for: October, 2014

October 29, 2014
Category: Cosmetic Dentistry
Tags: Crowns   Bridges  

In dental terms, crowns and bridges are both oral devices which are cemented onto existing teeth and can only be removed by a dentist, except for some removable bridges that can be taken out for cleaning. Both crowns and bridges act to maintain the proper positioning of teeth by filling in where teeth are missing or partially removed, and both help to improve the natural look of a person's smile by blending in with other teeth.

Whereas a crown is a kind of cap placed over a partial tooth, a bridge replaces a missing tooth or teeth in the mouth and is usually cemented onto adjacent teeth or crowns. In the past, these devices were often, at least partially, constructed of metal, and this was noticeable even if the metal part was covered by porcelain, because the dark metallic part was often evident.

Modern preparation of crowns and bridges is more sophisticated and does a better job of blending in with existing teeth. Crowns and bridges can now be constructed without the use of any metal, and can be entirely made of porcelain or ceramic, which matches the look of existing teeth to a much greater degree. Ceramic crowns can be prepared in one visit to a dentist's office, because they can be milled right on the premises, rather than having a mold taken which would be sent out to a laboratory, as in the past. Another huge benefit of ceramic crowns and bridges is the very natural coloring they provide, because they are completely constructed of ceramic colored to match other teeth in the mouth.

The materials used for construction of either a bridge or crown will usually depend on where in the mouth a tooth needs to be replaced or capped, because back teeth do not affect a smile as much as front teeth, so appearance is not as great a factor. In such cases, the stronger metal alloys can be used to add longer life to a crown or bridge, and it can still have a porcelain or ceramic veneer to blend in. In the front of the mouth, however, where a smile does so much to add to a person's sense of well-being, an all-porcelain or all-ceramic composition may be the best choice. Modern dentistry has now provided options to have the best of both strength and durability, and optimum appearance.

Dr. Howell specializes in cosmetic dentistry and has been working with patients in the Louisville area since 1998. Click here to learn more about our cosmetic services or contact us if you have a specific question. We'll be happy to get back with you soon!

By James B. Howell, D.M.D.
October 24, 2014
Category: Dental Procedures

In his decades long career, pop-music chameleon David Bowie has gone through a dizzying series of transformations. And as he morphed from alien-inspired space oddity to fashion-forward international superstar, his smile benefited from some very dramatic ch-ch-ch-changes. While Bowie hasn't talked much about his dental treatments, a comparison of pictures from the mid 1970s to the mid '90s (not to mention a much-viewed youtube video on the subject) makes it clear: his tooth staining, misalignment and gum recession have been left behind like polyester bellbottoms.

But tooth makeovers aren't just for pop stars! Cosmetic dentistry can benefit anyone who's interested in improving their appearance, at any age. Often, treatment starts with a “smile analysis” — a review of the current aesthetics of your mouth, including the shape, spacing, color and alignment of the teeth, the appearance and general health of the gums, and the way the lips and gums frame the smile.

This analysis can help pinpoint some places where the overall look of your smile may need improvement, and it can also identify some specific treatments to make it better. It's even possible to see a simulation of what you'd look like after the treatments are complete, to help ensure that your goals are realistic and attainable. What are some of the most common cosmetic procedures?

For stained teeth, you can try in-office whitening with concentrated bleaching solutions, or professionally-supervised at-home treatments using plastic trays that are custom-made to fit your teeth. The major difference between the two is the amount of time you need — with in-office treatments, you'll see results right away, while at-home gels may require weeks.

Tooth bonding and restoration with composite resin is a relatively fast and easy way to fix minor to moderate chips, flaws and discoloration. Because the composite material bonds directly to the tooth itself, this method requires only minor tooth preparation, and is often completed in just one office visit.

If your teeth, like Bowie's, need more extensive restoration, dental veneers or crowns may be required. Veneers are super strong, wafer-thin coverings that fit over the front surface of your teeth. Besides giving you that “Hollywood white” smile, they can also lengthen teeth that are too small, correct misalignment and close gaps in your smile. To correct even more extensive problems, crowns (also called caps) can replace the entire visible portion of one or more teeth — or, if teeth are missing, a permanent, long-lasting dental implant can be placed.

Many adults are choosing orthodontics to correct problems of tooth position, alignment or spacing — in fact, some 20% of all orthodontic patients today are grown-ups! It's never too late to start treatment, and with less-noticeable appliances like clear aligners and tooth-colored braces, it's easier than ever to make those ch-ch-ch-changes.

If you would like more information about the options available in cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Cosmetic Dentistry.”

October 22, 2014
Category: Uncategorized
Tags: Untagged
Coming soon.
By James B. Howell, D.M.D.
October 09, 2014
Category: Oral Health

Sometimes what’s going on in the mouth may point to a deeper issue. Although unpleasant to address, a dental examination could reveal signs of an eating disorder.

There are two disorders in particular that can adversely affect oral health: bulimia nervosa, characterized by food binging followed by purging through self-induced vomiting; and anorexia nervosa, characterized by self-starvation behavior. Occasionally, patients with one disorder may display behavior associated with another disorder.

“Binge-purge” behavior patterns are especially damaging to tooth enamel. When teeth are exposed to high levels of acid, the minerals in tooth enamel soften and erode. This is common with patients who overuse sodas, sports drinks and juices with high levels of citric acid. But bulimic patients also experience it because of stomach acid residue in the mouth after purging.

Patients with eating disorders also encounter other problems in the mouth. The salivary glands may become enlarged, giving the sides of the face a puffy appearance. The throat, palate and back of the tongue may appear red and damaged caused by fingers or other objects used to induce gagging.

There are also some differences between the two disorders in their effect on dental health. Anorexics tend to neglect grooming habits, including daily oral hygiene, which can lead to tooth decay and gum disease. Bulimic patients, on the other hand, are very mindful of body image and practice excellent grooming habits — but to a fault. In fact, aggressive brushing (especially after purging when high acid has caused enamel softening) can actually cause more erosion.

In the short-term, it’s important to treat dental problems caused by eating disorder behaviors, as well as encouraging better hygiene practices like waiting a few minutes to brush after purging or by rinsing with a little baking soda and water to help neutralize the acid. Ultimately, though, the eating disorder itself needs to be addressed and treated. In addition to your personal healthcare providers, the National Eating Disorders Association ( is a good online source for information and referrals.

Although a sensitive issue, an eating disorder can’t be ignored. Because of its effect on all aspects of health, including the teeth and mouth, the sooner it’s addressed, the better the outcome for patients and their families.

If you would like more information on the effect of eating disorders on oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Bulimia, Anorexia & Oral Health.”

October 07, 2014
Category: Uncategorized
Tags: Untagged

Do you have dentures that don't fit any more? Is there pain when you eat or put any pressure on your dentures? Or, have your parents or grandparents lost weight because they are eating less and less due to ill-fitting dentures?

It is important to note that not everyone can wear dentures comfortably. Bone support under the gums is the variable that determines adequate surface area for a denture or removable appliance. Bone support changes over time, and if teeth aren't present, there is typically more loss of bone over time. This means that long term denture wearers will have a more difficult time with removable teeth replacement appliances like dentures or partial dentures.

The Solution for Loose Dentures

Mini dental implants offer a reasonable solution to the problem of loose dentures. These implants can be placed in strategic areas to give stability to dentures or partial dentures. Instead of having a denture rest solely on gum tissue, the denture is supported by implants which are fixed and fully incorporated into the bone.

Dr. Howell has been trained in the placement of these implants to aid patients with stability in their dentures or partial dentures. Our office is located in the east end of Louisville just off Dutchman's Lane. To determine if you're a candidate for dental implants call (502) 899-7766, or click here to learn more about the procedure. We welcome new patients and are excited to meet you!

Louisville, KY Cosmetic Dentistry
James B. Howell, D.M.D.
3936 Dutchmans Lane
Louisville, KY 40207
(502) 899-7766



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